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dc.contributor.authorMcCallum, Gabrielle B
dc.contributor.authorMorris, Peter S
dc.contributor.authorGrimwood, Keith
dc.contributor.authorMaclennan, Carolyn
dc.contributor.authorWhite, Andrew V
dc.contributor.authorChatfield, Mark D
dc.contributor.authorSloots, Theo P
dc.contributor.authorMackay, Ian M
dc.contributor.authorSmith-Vaughan, Heidi
dc.contributor.authorMcKay, Clare C
dc.contributor.authorVersteegh, Lesley A
dc.contributor.authorJacobsen, Nerida
dc.contributor.authorMobberley, Charmaine
dc.contributor.authorByrnes, Catherine A
dc.contributor.authorChang, Anne B
dc.date.accessioned2017-12-15T03:37:32Z
dc.date.available2017-12-15T03:37:32Z
dc.date.issued2015
dc.identifier.issn2296-2360
dc.identifier.doi10.3389/fped.2015.00032
dc.identifier.urihttp://hdl.handle.net/10072/141919
dc.description.abstractBackground: Bronchiolitis is a major health burden in infants globally, particularly among Indigenous populations. It is unknown if 3 weeks of azithromycin improve clinical outcomes beyond the hospitalization period. In an international, double-blind randomized controlled trial, we determined if 3 weeks of azithromycin improved clinical outcomes in Indigenous infants hospitalized with bronchiolitis. Methods: Infants aged ≤24 months were enrolled from three centers and randomized to receive three once-weekly doses of either azithromycin (30 mg/kg) or placebo. Nasopharyngeal swabs were collected at baseline and 48 h later. Primary endpoints were hospital length of stay (LOS) and duration of oxygen supplementation monitored every 12 h until judged ready for discharge. Secondary outcomes were: day-21 symptom/signs, respiratory rehospitalizations within 6 months post-discharge and impact upon nasopharyngeal bacteria and virus shedding at 48 h. Results: Two hundred nineteen infants were randomized (n = 106 azithromycin, n = 113 placebo). No significant between-group differences were found for LOS (median 54 h for each group, difference = 0 h, 95% CI: −6, 8; p = 0.8), time receiving oxygen (azithromycin = 40 h, placebo = 35 h, group difference = 5 h, 95% CI: −8, 11; p = 0.7), day-21 symptom/signs, or rehospitalization within 6 months (azithromycin n = 31, placebo n = 25 infants, p = 0.2). Azithromycin reduced nasopharyngeal bacterial carriage (between-group difference 0.4 bacteria/child, 95% CI: 0.2, 0.6; p < 0.001), but had no significant effect upon virus detection rates. Conclusion: Despite reducing nasopharyngeal bacterial carriage, three large once-weekly doses of azithromycin did not confer any benefit over placebo during the bronchiolitis illness or 6 months post hospitalization. Azithromycin should not be used routinely to treat infants hospitalized with bronchiolitis. Clinical trial registration: The trial was registered with the Australian and New Zealand Clinical Trials Register: Clinical trials number: ACTRN1261000036099.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherFrontiers Research Foundation
dc.relation.ispartofpagefrom32-1
dc.relation.ispartofpageto32-9
dc.relation.ispartofjournalFrontiers in Pediatrics
dc.relation.ispartofvolume3
dc.subject.fieldofresearchClinical Sciences not elsewhere classified
dc.subject.fieldofresearchPaediatrics and Reproductive Medicine
dc.subject.fieldofresearchOther Medical and Health Sciences
dc.subject.fieldofresearchcode110399
dc.subject.fieldofresearchcode1114
dc.subject.fieldofresearchcode1199
dc.titleThree-weekly doses of azithromycin for Indigenous infants hospitalized with bronchiolitis: a multicentre, randomized, placebo-controlled trial
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
dcterms.licensehttps://creativecommons.org/licenses/by/4.0/
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© 2015 McCallum, Morris, Grimwood, Maclennan, White, Chatfield, Sloots, Mackay, Smith-Vaughan, McKay, Versteegh, Jacobsen, Mobberley, Byrnes and Chang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
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gro.griffith.authorSmith-Vaughan, Heidi
gro.griffith.authorGrimwood, Keith


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